The Nutri-Score for a Healthy Diet: Pros and Cons

Packaging labels must provide comprehensible nutritional information for consumers and represent a crucial educational tool to prevent non-communicable diseases such as metabolic syndrome, cardiovascular diseases, and cancers. Since 2017, France and other European countries have adopted the 5-color Nutri-Score label. This review describes Nutri-Score and analyses the latest evidence over the last two years regarding the strengths and weaknesses of Nutri-Score. Although various recent large studies correlated the application of the Nutri-Score algorithm (the purchases of some healthy products) and the lower risk of developing chronic diseases, further studies are necessary to evaluate these relationships with a large range of products in a real-life supermarket. The validation of a unique front-packaging label model remains controversial, and to date, no consensus has been reached. Several aspects need to be improved in the algorithm, such as the consideration of the degree of processing and the presence of food additives. Probably, the combination of various front-of packages labels could be the solution. In any case, its validity should be assessed by European scientific food authorities such as EFSA with further large human studies in real-life purchase conditions

Polypharmacy and malnutrition in older people: A narrative review

Polypharmacy is the simultaneous use of multiple medicines, usually more than five. Polypharmacy is highly prevalent among older individuals and is associated with several adverse health outcomes, including frailty. The role of polypharmacy in nutritional status seems to be crucial: although a clear association between polypharmacy and malnutrition has been widely reported in older people, the magnitude of the effect of increased number of drugs in combination with their type on the risk for malnutrition remains to be largely explored. Therefore, this review aims to discuss the association between polypharmacy and malnutrition in older people and to provide suggestions for its management. Polypharmacy is prevalent among malnourished frail patients, and the relative contribution of comorbidities and polypharmacy to malnutrition is difficult to be determined. Several mechanisms by which commonly used medications have the potential to affect nutritional status have been identified and described. Deprescribing (i.e., a systematic process of identification and discontinuation of drugs or a reduction of drug regimens) could be an essential step for minimizing the effects of polypharmacy on malnutrition. In this regard, the literature suggests that in older patients taking several medications, the best method to solve this problem is the comprehensive geriatric assessment, based on a holistic approach, including drug review, to find potential unnecessary and inappropriate medications. Nutritional and deprescribing interventions must be tailored to patient needs and to the local context to overcome barriers when applied in different settings

Food additives as non-conventional modulators of gut microbiota: health implications

Every day, billions of individuals consume variable amounts of food additives contained in most ultra-processed foods, even though these substances are considered non-nutritive. The market for these compounds is growing, as well as the incidence of non-communicable diseases (NCDs). Recent evidence suggests the detrimental role of food additives on gut microbiota and homeostasis as crucial players in the onset of NCDs. This review summarizes the main findings about this hot topic dissecting the most recent studies justifying the growing scientific concern about these non-nutritive substances. At least four categories of food additives have been put under the spotlights: artificial sweeteners, emulsifiers, food colorants, and preservatives. Human studies on a large scale are warranted to confirm preclinical results

Impact of artificial meat as novel food: controversies and future perspectives

Artificial meat, also called «synthetic», «cultured», or «in-vitro» meat, is growing in interest worldwide as a possible alternative protein source to regular meat derived from farm animals. Artificial meat production starts from an isolated muscle cell taken from a live animal and then cultivated to form slices of artificial meat with taste, texture, and look similar to regular meat. On the one hand, artificial meat can be considered safer since it is more uncontaminated from a microbiological point of view; on the other hand, the high level of cellular replication used in the production mechanisms can lead to a dysregulation of the DNA. While fats amount and type could be better than regular meat, protein intake may be the same, but iron and vitamin intake is still unclear. The impact on human health is poorly studied, and its impact on gut microbiota remains unknown. Moreover, the impact on the environment is still under debate. Well-designed studies are needed to evaluate better the impact of using artificial meat as a substitute for regular meat on human health, gut microbiota, and the environment

Spices and gastrointestinal health benefits: a state-of-the-art

Spices represent the basis of traditional medicine through the Middle East to Eastern Mediterranean and Europe since antiquity. In Western countries, spices are frequently used to impart flavor, reduce the need for salt and fatty condiments, improve digestion, and enhance their antioxidant effects. Thus, their diet-health linkages have drawn the attention of consumers, the scientific community, and the food industry. Indeed, their bioactive components are of considerable significance, making spices promising components to be included in a personalized diet. Numerous studies have demonstrated that spices have potential antioxidant, antimicrobial, and gastro-protective properties, and the role diet plays in preventing and treating many illnesses has been dissected. This review presents an overviewof the most common spices highlighting their anti-inflammatory, prebiotic, and anti-tumoral properties. Human clinical trials, specifically randomized controlled trials, are necessary to describe and demonstrate their health benefits to define it as a functional food

Botanicals in human nutrition: focus on bioactive food-derived compounds on gut microbiota in gastrointestinal inflammatory diseases

The interest of botanicals in human nutrition is a growing and promising field. However, these substances are still neglected or poorly understood in clinical practice. Since they are metabolized by the gut microbiota, the rationale for their effectiveness could rely not only on their nutritional properties but also on their prebiotic effects. By the way, an interesting field of research is the gastrointestinal tract. We conducted a literature review investigating the role of several nutraceuticals in chronic gut inflammatory and irritable diseases. We carry out a research on Pubmed – using MeSH terms – on the role of nutraceuticals such as Punica granatum (pomegranate), Ribes nigrum (blackcurrant), Vaccinium myrtillus (blueberry), Vaccinium macrocarpon (cranberry), Olea europea, Aronia melanocarpa (chokeberry), and inulin. We found preclinical and clinical studies confirming a striking potential role of these nutraceuticals in reducing gut inflammation in such conditions through gut eubiosis restoration. However, their effects could not be easily reached only by the food source assumption due to the large food amount needed to reach their therapeutic dosages. Thus, it appears useful to use the dry extract of fruits (or plants) in food for special medical purposes to ensure efficacy and long-term adherence to therapy. Further studies on clinical practice are warranted to confirm this preliminary evidence

Evidence-based tailored nutrition educational intervention improves adherence to dietary guidelines, anthropometric measures and serum metabolic biomarkers in early-stage breast cancer patients: A prospective interventional study

Purpose: The impact of the adherence to dietary guidelines of early-stage breast cancer (EBC) patients on body composition changes during treatment is not entirely defined. This study aimed to evaluate the role of an evidence-based nutrition educational intervention, according to adherence to dietary guidelines, in EBC patients. Methods: This prospective study included EBC patients, candidates for neoadjuvant/adjuvant therapy. Patients received an evidence-based tailored nutrition educational intervention. The adherence to dietary guidelines, anthropometric and dietary assessments, and blood glucose and lipid profile tests were evaluated at baseline and after a 12-months nutritional intervention. Results: Two hundred and forty-three patients were enrolled. At baseline, 38.3% and 23.9% of patients were overweight and obese, weight gain ≥5% (compared to 6-months before enrollment) and central obesity were observed in 47.3% and 52.7% of patients, respectively. Adherence to dietary guidelines was low (median Med-Diet score: 6 [IQR 4-8]). After the nutritional intervention (median follow-up: 22 months [range 12-45]), adherence to dietary guidelines significantly increased (median Med-Diet score: 12 [IQR 8-13]), p < 0.0001). High adherence to dietary guidelines (defines as Med-Diet score ≥10) significantly correlated with: 1) overall weight loss ≥5% (21.8% vs. 2.5%, p = 0.003); 2) median BMI drop (from 25.6 kg/m2 to 24.4 kg/m2, p = 0.003); 3) lower prevalence of central obesity (38.2% vs. 7.2%, p = 0.01); 4) improvement in blood glucose levels and lipid profile. Conclusion: This study suggests that an evidence-based tailored nutrition educational intervention during treatment for EBC significantly increases overall adherence to dietary guidelines, and it improves both anthropometric measures and serum metabolic biomarkers in patients with high adherence

Clinical Impact of Nutritional Status and Sarcopenia in Pediatric Patients with Bone and Soft Tissue Sarcomas: A Pilot Retrospective Study (SarcoPed)

Background: We evaluated nutritional and sarcopenia status and their clinical impact in pediatric patients affected by bone and soft tissue sarcomas. Methods: Body mass index (BMI), prognostic nutritional index (PNI), and total psoas muscle area (tPMA) at diagnosis and after 12 months were analyzed. tPMA was measured from single cross-sectional computed tomography (CT) images at L4-L5. Age-specific and sex-specific tPMA Z-scores were retrieved from an online calculator. Results: A total of 21 patients were identified between February 2013 and December 2018. Twelve patients (57.1%) experienced sarcopenia at diagnosis, although not statistically associated with overall survival (OS) (p = 0.09). BMI Z-score, PNI, and tPMA Z-score significantly decreased between diagnosis and after 12 months of treatment (p < 0.05). Univariate analysis showed significant associations between poor OS and the presence of metastasis (p = 0.008), the absence of surgery (p = 0.005), PNI decrease (p = 0.027), and the reduction in tPMA > 25% (p = 0.042) over the 12 months. Conclusions: Sarcopenia affects more than half of the patients at diagnosis. Decreased PNI during 12 months of treatment has significant predictive value for OS. The role of tPMA derived from CT scan among pediatric patients with sarcoma should be investigated in further prospective and larger studies

Low fT3/fT4 ratio as a proxy for muscle wasting in patients with advanced non-small cell lung cancer treated with pembrolizumab

BackgroundLoss of skeletal muscle mass may serve as a valuable indicator of treatment efficacy and survival in individuals with lung cancer undergoing immunotherapy. This investigation sought to pinpoint accessible markers that could reflect the presence of muscle degradation.MethodsA retrospective study was conducted on patients with advanced non-small cell lung cancer (NSCLC) who received first-line pembrolizumab therapy from June 2018 to September 2021. Data collected included computed tomography (CT)-based body composition, clinical and radiological characteristics, along with thyroid function tests (free triiodothyronine [fT3] and free thyroxine [fT4]). Predictive factors were evaluated using multivariate logistic regression models.ResultsAmong 31 patients, muscle wasting was observed in 58.1%. Performance Status (PS) emerged as a strong predictor (p=0.005), and a significant link was also found between muscle depletion and fT3/fT4 ratio (p=0.0296). After adjusting for PS, the association with the hormone ratio remained suggestive though not statistically definitive (p=0.091). ROC curve analysis identified a threshold value of 2.84 for fT3/fT4 ratio, which best differentiated patients at higher versus lower risk of muscle loss. Notably, 77.3% of individuals with muscle wasting had a ratio below this cut-off, compared to only 14.3% of those with higher ratios (p=0.006). While no significant correlation was found between the hormone ratio and progression-free survival (PFS), a meaningful association with overall survival (OS) was observed (p=0.032).ConclusionsDespite the limited sample size, fT3/fT4 ratio appears to be a promising and accessible biomarker for identifying muscle wasting, which may be linked to diminished treatment response and shorter survival in patients with NSCLC